On SCHIP

Reauthorizing the State Children’s Health Insurance Program (SCHIP) has proven more complicated than it should have been. Started by a Republican Congress more than a decade ago, Congressional Democrats have made the program their own with a plan to rapidly expand its size and scope.

The first battle in the war over fiscal responsibility this fall will be fought over SCHIP terrain, a battlefield not particularly friendly to the Republican position. House Speaker Nancy Pelosi (D-Calif.) has already taken to calling the president and his allies anti-children, demagoguery that is completely effective in the short term. Bush’s retort that this expansion is the first step to government-run healthcare appeals to a small band of ideological purists, but largely fails to convince the public at large.

Nobody is talking about the moral implications of sharply raising taxes on the poorest Americans (most smokers are low-income) to pay for an expansion of a benefit to middle-class Americans. Nobody is talking about the fact that 22 million more Americas are going to have to take up the smoking habit in order to make up for the budget shortfall that will surely occur when cigarette tax revenue fails to meet expectations. Nobody is talking about the ironic fact that once these kids grow up they are going to have to pay the bills for this program, which will only increase the deficit.

This is not good ground for the Republicans to hold. So they need to find an alternative to turn to quickly, once the president vetoes the bill.

Sen. Mel Martinez (R-Fla.) has crafted such an alternative, one that can get the president’s signature, help all kids get health insurance and not stick it to smokers. It has three elements. First, it includes a full reauthorization of SCHIP. Families that are at or below 200 percent of the federal poverty level get the same benefits. Second, those families that are between 200 and 300 percent of the poverty level would get a child healthcare tax credit that would be used for the purchase of health insurance. Third, Martinez would create a healthcare federalism initiative for the states, to give them incentives to expand healthcare coverage at the state level.

House Republicans need such an alternative, because the focus will be on them during this veto fight. It is quite likely that the Senate will vote to override the president. And while fiscal responsibility sounds good in the abstract, it loses its appeal in the context of kids’ health.